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Lateral Violence: Ending Incivility in the Nursing Profession

Too often, nurses faced with the weight of oppressive work conditions have lashed out at other nurses. The everyday politics of oppression created and continues to generate tensions that lead to lateral violence in nursing or what is now called a “lack of civility”.[i]

The phrase “nurses eat their young” is itself a perpetuation of these phenomena, generalizing and too often normalizing lateral violence by nurses.

The first step in getting out from under the weight of our oppressed group behavior is to recognize and name lateral violence. Lateral violence may result in a wide range of behaviors such as:

Nonverbal innuendo

Verbal affront such as belittling

Undermining actions; unavailability

Withholding information

Sabotage; or “setting up to fail”

Infighting

Scapegoat

Backstabbing

Failure to respect privacy

Broken confidences[ii]

Griffin (2007) suggests that in addition to naming lateral violence, nurses need to take a stand for “zero tolerance”.The costs of lateral violence in nursingare enormous and include nursing staff turnover and impaired quality of nursing care.Therefore, there needs to be a strong commitment from the “top down as well as bottom” up to eradicate the behaviors, many of which begin in nursing education.

Nurse educator and researcher Cynthia Clarke has noted that nursing students need to experience and learn civil behaviors on the part of faculty and health care staff to bring nurses out from under the rock of nurse oppression.[iii]From zero tolerance, the culture of nursing needs to further empower nurses to speak-up and support one another.

Everyday, nurses are making the history of tomorrow.We cannot afford to be “victims” of the past nor passive recipients or active perpetrators of lateral violence in nursing.Our challenge as nurses is to create a new history built on respect and support. This will build a work culture that is not just good for nurses, but also conducive to promoting quality health care outcomes for our patients.

[i] Nurses oppressed group behavior has been described by nurse theorist, Dr. Susan Jo Roberts in Andrist, Nicholas & Wolf (2006) A History of Nursing Ideas, and more recently has been readdressed as lateral violence by such groups as the American Nurses Association.More recently, nurse scholar, Dr. Cynthia Clarke has published several articles on “civility and nursing. See the references below for a link to one of her well read articles.

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Great article. In answer to Meg's question, if you find yourself in a job where the culture set by management is one where lateral violence is accepted, move on to a healthier environment. The culture is set by nursing management. The good news is there are many healthy organizations that support their nurses.

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In reference to Meg and Lisa the area where I live has a very small healthcare community and when I spoke up there was retaliation now I can't find a job if I had a clue the consequences I never would have said anything.